A Supplement To

CME Post-Test
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Official Journal of the

International Society of
FOR EACH QUESTION, CHOOSE THE CORRECT ANSWER FROM THE
Gastrointestinal Oncology
MULTIPLE-CHOICE LIST.

1. For patients with stage II or III rectal cancer for whom tumoral downsizing is advantagous
or sphincter preservation is desired, what is the preferred preoperative treatment?
a. Short-course radiotherapy (5  5 Gy) alone
b. Long-course chemoradiotherapy (1.8 Gy/day)
c. Neoadjuvant chemotherapy

2. Based on current studies in patients with rectal cancer, the most reliable predictor of survival
after undergoing long-course neoadjuvant chemoradiotherapy and surgery is:
a. Pretreatment clinical stage
b. Degree of response to neoadjuvant treatment
c. Final pathologic stage (ypTNM)

3. In patients with metastatic colorectal cancer, what is among the most important
predictors for recurrence after resection of liver metastases?
a. Number of liver metastases
b. The progression of the primary colorectal cancer
d. Presence of pulmonary metastases
e. Achievement of a simultaneous resection rather than a staged resection

4. What is the primary contributor to the rising incidence of hepatocellular carcinoma?

a. Hepatitis A infection
b. Hepatitis B infection
c. Hepatitis C infection
d. Metabolic syndrome related to obesity, diabetes mellitus, and non-alcoholic fatty liver
disease

5. In patients with hepatocellular carcinoma who are to undergo local ablation for small,
solitary, or a limited number of lesions, which of the following is considered the treatment
of choice?
a. Radiofrequency ablation (RFA)
b. Percutaneous ethanol injection (PEI)
c. Cryoablation
d. Intra-arterial injection of yttrium-90 microspheres

6. Biliary tract cancers that arise in the biliary bifurcation are called:
a. Gallbladder cancer
b. Intrahepatic cholangiocarcinoma [IHCC]
c. Extrahepatic cholangiocarcinoma [EHCC]
d. Hilar cholangiocarcinoma

7. Regarding systemic adjuvant therapy for patients with biliary tract cancers:
a. Cisplatin + gemcitabine has shown promise in this setting
b. Systemic 5-fluorouracil for 1 year beyond the period of chemoradiotherapy is
a new standard
c. There is currently no accepted standard adjuvant treatment
d. None of the above

S80 Gastrointestinal Cancer Research Volume 3 • Issue 5 • Supplement 2

 CME Post-Test (cont’d)
8. Data from cohort studies of U.S. women with pancreatic adenocarcinoma suggest that
which of the following risk factors contributes the greatest risk for this disease?
a. Smoking
b. Increasing body mass index
c. High alcohol intake
d. History of diabetes

9. In the CONKO-001 trial, which of the following treatments had a significant benefit in
patients with resected pancreatic cancer?
a. Adjuvant chemoradiotherapy
b. Adjuvant 5-fluorouracil
c. Adjuvant gemcitabine
d. Gemcitabine plus erlotinib

10. The first randomized trial to demonstrate a meaningful overall survival benefit of
second-line therapy for patients with pancreatic cancer was:
a. The second part of the CONKO 003 trial, which resulted in significantly better
outcomes for patients treated with 5-fluorouracil/folinic acid/oxaliplatin, as
compared with 5-fluorouracil/folinic acid
b. The phase III trial of gemcitabine with or without erlotinib
c. The AVITA trial, which compared gemcitabine/erlotinib + bevacizumab vs.
gemcitabine/erlotinib
d. The randomized phase II study of gemcitabine plus axitinib vs. gemcitabine alone

11. Which of the following tumor types seems to be more responsive to chemotherapy?
a. Carcinoid tumors
b. Neuroendocrine tumors

12. Deficiency of the DNA repair enzyme, O6-methylguanine DNA methyltransferase

(MGMT), appears to be more common in which type of tumor?
a. Carcinoid tumors
b. Pancreatic neuroendocrine tumors

13. In localized gastric cancer, accepted treatment strategies outside of Japan include:
a. Gastrectomy alone
b. Neoadjuvant chemoradiation or chemotherapy, then surgery
c. Perioperative chemotherapy or adjuvant chemoradiation

14. Key phase III trials reporting a survival advantage for multi-modality therapy in localized
gastric cancer are:
a. CRITICS, CLASSIC, Intergroup CALGB-80101
b. MAGIC, Intergroup 0116/SWOG-9008, ACTS-GC
c. ARTIST, ST03, JCOG-0501

September/October 2009 www.myGCRonline.org S81

 A Supplement To

CME Post-Test (cont’d)

Official Journal of the
International Society of
15. Which statement best describes the epidemiologic changes for esophagogastric cancer in
Gastrointestinal Oncology
Western countries?
a. There have been no significant changes in the incidence of gastric cancer over the
past 35 years
b. There has been a significant increase the incidence of esophageal adenocarcinoma
over the past 35 years
c. There has been a significant increase in the incidence of distal gastric cancer over the
past 35 years
d. There has been a significant decrease in the incidence of proximal gastric cancer over
the past 35 years
e. There has been a significant increase in the relative incidence of proximal gastric
cancer but a significant decrease in the incidence of esophageal adenocarcinoma over
the past 35 years

16. Which statement about the treatment of metastatic esophagogastric cancer is NOT CORRECT?
a. So-called doublet or triplet combinations (platinum/fluoropyrimidine or platinum/
fluoropyrimidine plus third drug) are widely used
b. Oxaliplatin is at least as effective as cisplatin
c. The oral fluoropyrimidine capecitabine is at least as effective as 5-fluorouracil
d. Irinotecan is more effective and more tolerable than cisplatin
e. Several targeted drugs are under clinical investigation

17. Which KIT mutation genotype is associated with the best response to imatinib?
a. Exon 9
b. Exon 11
c. Exon 18
d. KIT wild type

18. Which of the following is (are) important prognostic factor(s) for completely resected GISTs?
a. High mitotic rate
b. Tumor size
c. Tumor location
d. Tumor rupture
e. All of the above

19. In recent analysis of patients with colorectal cancer, the prevalence of PI3K mutations was:
a. Approximately 40%
b. 12% – 13%
c. 75%

20. At present, which of the following is the most reliable marker of increased colon cancer
risk in patients with inflammatory bowel disease?
a. Mutations in p53
b. Mutations in KRAS
c. Mutations in APC genes
d. Morphologic identification of dysplasia in mucosal biopsies

S82 Gastrointestinal Cancer Research Volume 3 • Issue 5 • Supplement 2